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T.R. Reid on “U.S. Health Care: The Good News”

The United States is the only industrialized democracy that doesn’t provide health care for all its citizens. Of course, we’d like to cover all of the 50 million uninsured, but how would you pay for it?

In fact, we could. The view among health policy experts is that Americans pour enough money into health care to have universal coverage. “It’s generally agreed,” says Dr. Elliott Fisher, of the Dartmouth Institute for Health Policy, “that about 30 percent of what we spend on health care is unnecessary. If we eliminate the unneeded care, there are more than enough resources in our system to cover everybody.”

These are not the phantom savings on “waste and fraud” that politicians always talk about in this $2.6 trillion industry. These are communities across America finding ways to cut costs while still providing excellent care. These places –from big cities to rural outposts – could be the model for achieving large savings in American medicine with no loss of quality.

U.S. Health Care: The Good News examines those high-value communities. In the documentary I travel from coast to coast, visiting doctors and hospitals that care about the fiscal health of their communities as well as the physical health of their patients.

The film is based on the work of Dr. Fisher and his colleagues at Dartmouth, who publish The Dartmouth Atlas of Health Care. Their work began in the 1970s, when doctors and economists began reviewing Medicare billing records by the millions. They found something amazing: Massive variation from one town to the next in the treatment of the same ailment. Some U.S. counties, for example, spend $17,000 per year on the average Medicare patient while others spend less than $7,000 annually with similar results.

The film looks at a few of these high-quality, low-cost regions of the country, to learn how they do it in small, rural private practices and big-city clinics. For all the differences, the communities have several important things in common, including a clear commitment by doctors and hospitals to lower the cost of health care.

We hope you learn from our film. And we hope it will galvanize people like you to demand high-quality care at reasonable cost from your own local doctors and hospitals.